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General NPI Number Information
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NPI Number | 1861294654
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Entity Type | Individual
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Provider Name | AMANDA GOLD OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 82 BETHANY RD STE 1
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City | HAZLET
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State | NJ
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Zip | 07730-1459
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Country | US
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Telephone | 732-888-3912
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Fax |
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Provider Business Mailing Address
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Address Line | 3 MACINTOSH CT
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2854
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Country | US
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Telephone | 732-579-7130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 46TR01230200
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License Number State | NJ
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